Individual provider · Type 1 NPI

Raevin Nickerson, RAD-T

Addiction (Substance Use Disorder) Counselor · Fairfield, CA

NPI number 1487438594 Active

Practice location

1225 Travis Blvd
Fairfield, CA 94533-4892

Call (707) 399-9105 Map

Mailing address

609 Jefferson St
Fairfield, CA 94533-6293

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XR1521270823 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1487438594

Raevin Nickerson, RAD-T's National Provider Identifier is 1487438594, issued on Aug 21, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fairfield, CA. The record was last updated on Aug 21, 2023.